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[Early bacterial infections after allogenic bone marrow grafts]
D Guyotat1, C Plotton, E Archimbaud
1Unité de Greffes de Moelle, Hôpital Edouard-Herriot, Lyon, France.
Abstract:
The bacterial infections occurring during the period of neutropenia have been reviewed in a series of 100 allogeneic bone marrow transplant patients. Forty episodes of septicaemia were observed, in 37 patients, with a large majority of Gram positive organisms (thirty cases). Only one case of major local infection occurred (Gram negative meningitis). A non-bacterial infection was seen in 10 patients, and 36 patients presented with fever of unknown origin. Three patients who failed to engraft died of bacterial infection. Surveillance cultures showed that upper respiratory tract was a frequent site of invasion, not only for Gram positive, but also for Gram negative organisms (Pseudomonas aeruginosa).
Insights
Bacterial infections, primarily Gram-positive, are common in neutropenic patients post-allogeneic bone marrow transplant. The upper respiratory tract frequently harbors bacteria, including Pseudomonas aeruginosa.
Area of Science:
- Hematology
- Infectious Diseases
- Transplantation Immunology
Context:
- Neutropenia following allogeneic bone marrow transplantation (BMT) significantly increases infection risk.
- A cohort of 100 allogeneic BMT patients was retrospectively analyzed.
- Understanding infection patterns is crucial for patient management.
Purpose:
- To review bacterial infections in neutropenic patients undergoing allogeneic BMT.
- To identify common pathogens and infection sites.
- To assess the incidence of non-bacterial infections and fever of unknown origin.
Summary:
- Forty episodes of septicemia occurred in 37 patients, predominantly caused by Gram-positive organisms (30 cases).
- Only one major Gram-negative meningitis was reported; 10 patients had non-bacterial infections, and 36 experienced fever of unknown origin.
- Surveillance cultures identified the upper respiratory tract as a common invasion site for both Gram-positive and Gram-negative bacteria, including Pseudomonas aeruginosa.
Impact:
- Highlights the high burden of bacterial infections, especially Gram-positive, in this vulnerable population.
- Underscores the importance of respiratory tract surveillance for both Gram-positive and Gram-negative pathogens.
- Informs strategies for infection prevention and empirical treatment in neutropenic BMT recipients.